Botulinum toxin (Botox) is a potent muscle relaxant, and has been used in vaginismus and pelvic pain cases with great success. A fine needle injection into the spastic muscles will effectively relax the muscles and temporary paralyze it for 3 months, making intercourse possible, and a pleasurable experience.

Treatment includes, botulinum toxin vaginal injection with manual vaginal dilatation under general anesthesia. Afterwards the patient performs scheduled progressive self vaginal dilatation with special vaginal dilators for several months, this method provides better long lasting results, with acceptance of intimacy and intercourse in over 90% of cases in cosmetic gynecology.

Other methods of vaginismus management include psycho-sexual counseling, reassurance and vaginal widening procedures. Repeated Botox injection is rarely needed, but may be necessary in sever resistant cases. Botulinum toxin is also used for treatment of pelvic pain and resistant cases of urinary incontinence.